Quote from: Arianna Valentine on December 13, 2018, 01:11:48 PM
I don't think I will have that issue because I take my medicine before bed

If you can't accept yourself,  how can you expect others to accept you?

I would spread the E out through the day.  I do injections now, but when I did do pills I spread them out to keep a constant E level.

You can google puberty level estrogen, post puberty level estrogen, and pregnancy estrogen levels. Pregnant level estrogen can go very high! 

The goal is to stay in the high end of the puberty level of estrogen for a good 7 years. 

That's why I switched to injections.

Of course I'm not a doctor and this is my own opinion based off of my experience, doctors recommend dosages, and others experiences.  Consult with your doctor.  🙂

Pills have worked very well for me. I take one pill buccally three times per day with at least 6 hours between each dose.  This way of taking my pill was discussed thoroughly with my doctor and my provider's on-staff pharmacist, who gave me the okay. Placement is between cheek & upper gum, as far up as possible. If I don't have to talk or smile a lot the pill stays in place  and dissolves slowly for at least an hour, often up to 3 hours.  I look at it as having all the benefits of taking it sublingually, but with a much longer contact with mucous membranes in the mouth.

Lab results have shown a really high spike if the blood draw happens one to two hours after placing the pill. At around five hours my estrogen level is typically in the 200s. If only there were really good peer-reviewed studies and data on the efficacy of the various ways of taking estrogen for transition!

Quote from: Phlox1 on December 13, 2018, 01:06:09 PM

While I know everyone is a bit different, for me, it appears that taking the E pills under my tongue elevated my E level to perhaps an unhealthy level.  Something to be aware of.  Please be safe and take care of yourself.

It also depends very much on the dosage.  If your physician prescribed a rather high dosage, considering that not that much will reach your blood when taken orally, doing the same dosage sublingual will allow almost all of the active ingredients to reach your blood stream and have a high initial hormone level.
Any injection would cause a similar high level, if that is not the case, the injection may have a lower amount of active ingredients.
But of importance with the intake of Estrogen is not the initial level, but the average level over time,  I don't know if there is something existing like the A1c test for diabetes.  This test measures the blood sugar over a 3 month period, and gives a pretty accurate information on the average blood sugar level.  Something like this test would be ideal to give a reliable information on the average estrogen level

Quote from: RoryL on December 13, 2018, 01:41:25 PM

Lab results have shown a really high spike if the blood draw happens one to two hours after placing the pill. At around five hours my estrogen level is typically in the 200s. If only there were really good peer-reviewed studies and data on the efficacy of the various ways of taking estrogen for transition!

The problem here is that any standard lab test is only a single shot at a certain moment, and may not reflect your average estrogen level properly.
I think there are not studies, because the population of trans women is way to small  One would need a test group for each of the different levels to take estrogen, and a control group.  It should be at least a few 100 persons in every group to have a reliable sample size.
I don't think that any epidemiologist or related specialty is really hot about starting such a study.  And who would finance it?  Who would do the logistics?

Quote from: Dietlind on December 13, 2018, 01:41:31 PM
It also depends very much on the dosage.  If your physician prescribed a rather high dosage, considering that not that much will reach your blood when taken orally, doing the same dosage sublingual will allow almost all of the active ingredients to reach your blood stream and have a high initial hormone level.
Any injection would cause a similar high level, if that is not the case, the injection may have a lower amount of active ingredients.
But of importance with the intake of Estrogen is not the initial level, but the average level over time,  I don't know if there is something existing like the A1c test for diabetes.  This test measures the blood sugar over a 3 month period, and gives a pretty accurate information on the average blood sugar level.  Something like this test would be ideal to give a reliable information on the average estrogen level

Yeah, I think the best thing to do is take the test 4 to 6 hours after taking the pill.  Or a few days after one has their injection.

Then maybe have another test in a week or two, followed up by another test.

I never inject before my blood tests.  The last thing I want is my endo seeing my E levels in the 600 to 800 levels.

I'm pretty sure they do reach that high within 24 hours after my injection then drop to around 200 before my next injection.

I try to keep my E between 200 and 400.  It keeps my T in the 30's which is healthy for a female my age without taking spiro.  I quit taking spiro two years ago.  I don't need it anymore thank goodness.

Quote from: CindyLouFromCO on December 13, 2018, 01:37:08 PM
I would spread the E out through the day.  I do injections now, but when I did do pills I spread them out to keep a constant E level.

You can google puberty level estrogen, post puberty level estrogen, and pregnancy estrogen levels. Pregnant level estrogen can go very high! 

The goal is to stay in the high end of the puberty level of estrogen for a good 7 years. 

That's why I switched to injections.

Of course I'm not a doctor and this is my own opinion based off of my experience, doctors recommend dosages, and others experiences.  Consult with your doctor.  [emoji846]

Unfortunately I only get a 30 day supply and I'm supposed to take them once a day for now I do have a feeling that next month when I see my endocrinologist this will change but for now I follow her instructions except I have went from swallowing them to putting them under my tongue and I contacted her before I did that and she was okay with that

If you can't accept yourself,  how can you expect others to accept you?

Quote from: Arianna Valentine on December 13, 2018, 02:00:59 PM
Unfortunately I only get a 30 day supply and I'm supposed to take them once a day for now I do have a feeling that next month when I see my endocrinologist this will change but for now I follow her instructions except I have went from swallowing them to putting them under my tongue and I contacted her before I did that and she was okay with that

If you can't accept yourself,  how can you expect others to accept you?

How much estrogen do your pills contain? I have a 90 days supply of xx mg each and are supposed to take them once a day until I have my big blood test done next month.  I take the pills sublingual, but I have no idea what my blood level is.
I could take two of those a day to end up with xx mg, but I don't know what the results of that would be.  I do not want to have big boobs and a blood clot in my veins!  I rather stay with smaller bobs and no clots!
I assume that my testosterone level is pretty low, because of my long term ingestion of finasteride and now in addition spiro.  Spiro seems to wok, measuring with the increased number of trips to the bathroom!

Quote from: Dietlind on December 13, 2018, 01:51:27 PM
The problem here is that any standard lab test is only a single shot at a certain moment, and may not reflect your average estrogen level properly.
I think there are not studies, because the population of trans women is way to small  One would need a test group for each of the different levels to take estrogen, and a control group.  It should be at least a few 100 persons in every group to have a reliable sample size.
I don't think that any epidemiologist or related specialty is really hot about starting such a study.  And who would finance it?  Who would do the logistics?

The only somewhat related data I could find was from an NIH study in 1997 (might have the year wrong). It compared blood levels of estradiol & estrone over time for cisgender women who either swallowed the pill or took it sublingually.  S/L definitely showed a much higher spike, with about the same levels as swallowing five hours from administration.

I work in an academic medical center and often my visits with providers includes me promoting the idea of a study (ANY kind of trans-specific medical care study) since they're always looking to publish. Generally, there's not much of a response other than agreement that actual data would be nice to have.

At a guess, perhaps one of the Centers for Excellence for Transgender Healthcare would have the connections & awareness of funding opportunities to conduct or sponsor such research. They certainly would have access to an IRB and academics who specialize in designing research studies.

[EDIT] - corrected "estradiol & estrace" to "estradiol & estrone" 

Quote from: Arianna Valentine on December 13, 2018, 02:00:59 PM
Unfortunately I only get a 30 day supply and I'm supposed to take them once a day for now I do have a feeling that next month when I see my endocrinologist this will change but for now I follow her instructions except I have went from swallowing them to putting them under my tongue and I contacted her before I did that and she was okay with that

If you can't accept yourself,  how can you expect others to accept you?

I hope you get the results that you want, you seem to making good progress.
Enjoy your wonderful changes as they arrive.   

Chrissy

Quote from: RoryL on December 13, 2018, 03:19:09 PM

At a guess, perhaps one of the Centers for Excellence for Transgender Healthcare would have the connections & awareness of funding opportunities to conduct or sponsor such research. They certainly would have access to an IRB and academics who specialize in designing research studies.

As always with medical studies, one has to have an opinion leader who is willing to run with it and take ownership.  I almost feel that us transgender women are not exciting enough to find somebody to run with a study idea.
When we needed to publish data on one of the new developments of our lab, we could always find a leading surgeon to take control, but we also made all the money available for this opinion leader to be excited to run such a study.  It was always a win/win situation, the leader could publish, and we had our data!

But with us transgender women, who would be exited?  We don't take enough of medications to knock a pharma business of their stool.  I would need to be done by academia, but again, how much fame can be had from it?

Quote from: Arianna Valentine on December 13, 2018, 05:05:23 PM
1mg

If you can't accept yourself,  how can you expect others to accept you?

That is rather low.  My patches had  mg per day delivery, and as I told the endo that I do not feel any results of them, he increased it to xx mg.  He said we can go up to xx mg per day.

Are you taking anything else along with it.  As I said, I take the highest dose of finasteride for many years now (has nothing to do with being trans, but it helps a lot), and now spiro.  My testosterone levels should now be about as high as my basement here, and I have to see if I see any effects from estrogen now.
But again, I have that wired body configuration.  My body does not metabolize opioides, and the heck, it might not metabolize Estradiol either!  Who knows?

Quote from: Dietlind on December 13, 2018, 05:26:31 PM
That is rather low.  My patches had  mg per day delivery, and as I told the endo that I do not feel any results of them, he increased it to xx mg.  He said we can go up to xx mg per day.

Are you taking anything else along with it.  As I said, I take the highest dose of finasteride for many years now (has nothing to do with being trans, but it helps a lot), and now spiro.  My testosterone levels should now be about as high as my basement here, and I have to see if I see any effects from estrogen now.
But again, I have that wired body configuration.  My body does not metabolize opioides, and the heck, it might not metabolize Estradiol either!  Who knows?

My doctor started me out on a low-dose because she wants my breast and body growth to be more natural so it starts out as a low dose and gradually increases every 3 to 6 months so I'm guessing my next visit which is next month it'll probably increase again

If you can't accept yourself,  how can you expect others to accept you?

Quote from: Arianna Valentine on December 13, 2018, 05:38:11 PM
My doctor started me out on a low-dose because she wants my breast and body growth to be more natural so it starts out as a low dose and gradually increases every 3 to 6 months so I'm guessing my next visit which is next month it'll probably increase again

If you can't accept yourself,  how can you expect others to accept you?

This makes sense, the skin would not be stretched to much all of a sudden.  It took me well over 3 years to grow to my currently smallish B cup size,  That is the reason why I never had, and still don't have any pain in my breasts, just the nipples hurt once in a while, but that is not bad, the need a pretty hard contact to hurt.

Quote from: Dietlind on December 13, 2018, 07:19:56 PM
This makes sense, the skin would not be stretched to much all of a sudden.  It took me well over 3 years to grow to my currently smallish B cup size,  That is the reason why I never had, and still don't have any pain in my breasts, just the nipples hurt once in a while, but that is not bad, the need a pretty hard contact to hurt.

Oh my God I know all about nipple pain I was taking a tree limb off of my tree earlier today with both of my nephews and I went nipple first into the truck walking into it oh my God hurt so bad

If you can't accept yourself,  how can you expect others to accept you?

Ladies, please!

We are not allowed to mention dosages here on Susan's Place. We do not want to encourage self medication.

What you can see from all of this discussion is that the prescribed dose, schedule and route of administration all determine our blood levels. It is much safer for a trained professional to determine your dose. We are not all identical and we all have our own preferences, so discuss this with your Endocrinologist or other prescriber who is familiar with transgender issues.

Would one of the moderators please be so kind and remove the dosages from my last few posts?  While you ladies do this, I will spread ashes over my head and feel very guilty!

  Dani is correct in saying that TOS 8 prohibits discussing dosages. You may discuss most medications and you may even discuss pill strength as long as you don't provide enough information that it could be used to self medicate with. The thread has been corrected and is unlocked for discussion.   

My doc adding a T-blocker to the estrogen works for me. Our bodies are all different, so there's really no pat answer for everyone. A healthy diet and exercise are definitely important, so that the body can respond with maximum efficiency and without interference of the effects of bad foods and poor health.